过敏性疾病患儿食物sIgE和sIgG4检测结果分析  

Analysis of detection results of food-specific IgE and IgG4 in children with allergic diseases

作　　者：殷国煜 邱媛 YIN Guoyu;QIU Yuan(Department of Clinical Laboratory,Hangzhou Women′s Hospital,Hangzhou 310000,Zhejiang,China)

机构地区：[1]杭州市妇产科医院检验科,杭州310000

出　　处：《临床检验杂志》2024年第1期12-17,共6页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨食物特异性抗体IgE(sIgE)和特异性抗体IgG4(sIgG4)浓度水平在儿童过敏性疾病诊疗中的临床意义。方法选取2022年11月至2023年11月杭州市妇产科医院就诊的过敏性疾病患儿641例以及同期体检健康对照儿童100例,检测两组儿童血清中食物sIgE及sIgG4的表达水平。结果过敏性疾病患儿食物sIgE、sIgG4总阳性率分别为37.44%、90.48%,显著高于健康对照儿童的11.00%,61.00%,差异有统计学意义(P<0.05)。儿童主要食物过敏原是牛奶和鸡蛋白,sIgE强度集中在1~2级别,以单种食物阳性较为常见。sIgG4强度集中在3级,以多种食物为主。同种食物sIgE和sIgG4检测结果比较,sIgG4阳性率显著高于sIgE(P<0.05),二者检测一致性较差(κ<0.4)。不同性别患儿食物sIgE和sIgG4的阳性率差异均无统计学意义(P>0.05)。婴儿组食物sIgE阳性率、童年组食物sIgG4阳性率最高(P<0.05)。鸡蛋白、虾、螃蟹、腰果sIgE阳性率在皮肤系统组最高;鸡蛋白、牛奶sIgG4阳性率在呼吸系统疾病组最高,虾、小麦sIgG4阳性率在皮肤系统疾病组最高,差异均具有统计学意义(P<0.05)。过敏原组分解析显示,β-乳球蛋白、α-乳清蛋白、酪蛋白是牛奶中的重要致敏成分,卵类黏蛋白是鸡蛋白中的重要致敏成分。结论食物过敏是导致儿童过敏性疾病的重要因素,食物sIgE和sIgG4联合检测为临床诊疗及儿童个体化饮食指导提供了实验依据。Objective To investigate the clinical significance of the detection of food-specific IgE(fsIgE)and IgG4(fsIgG4)antibodies in the diagnosis and treatment of children′s allergic diseases.Methods A total of 641 children with allergic diseases visited Hangzhou Women′s Hospital during November 2022 and November 2023 and 100 healthy children during the same period were selected,and the levels of fsIgE and fsIgG4 in their serum samples were detected.Results The total positive rates of fsIgE and fsIgG4 in children with allergic diseases were 37.44%and 90.48%,respectively,which were significantly higher than the 11.00%and 61.00%of healthy children(P<0.05).The main food allergens in children were milk and eggs.The intensity of fsIgE was concentrated in the 1-2 level and the positive result for a single food was more common.The intensity of fsIgG4 was concentrated in Grade 3 and the positive results for multiple foods were more common.The comparison of the detection results of sIgE and sIgG4 to the same food showed that the positive rate of sIgG4 was significantly higher than that of sIgE(P<0.05),and the consistency between them was poor(κ<0.4).There were no significant differences in the positive rates of fsIgE and fsIgG4 between different genders(P>0.05).The highest positive rate of fsIgE was seen in the infant group and the highest positive rate of fsIgG4 was seen in the childhood group(P<0.05).The positive rates of sIgE to egg protein,shrimp,crab,and cashew were mainly seen in children with skin diseases(P<0.05).The positive rates of sIgG4 to egg and milk were mainly seen in children with respiratory diseases(P<0.05).The positive rates of sIgG4 to shrimp and wheat were mainly seen in children with skin diseases(P<0.05).Analysis of allergen components showed that theβ-lactoglobulin,α-whey protein,and casein in milk and mucin in eggs were important allergenic components.Conclusion Food allergy is an important factor leading to children′s allergic diseases.The combined detection of fsIgE and fsIgG4 can provide exp

关 键 词：过敏性疾病 食物特异性IgG4抗体 食物特异性IgE抗体 过敏原 

分 类 号：R446[医药卫生—诊断学]